Addressing the mental health impact of COVID-19 through digital therapies

Training, guidance and support are essential to ensure that digital therapies for mental health are effective during the COVID-19 pandemic and beyond, according to a new opinion piece co-written by Professor Dame Til Wykes from King’s College London.

Published in the journal JAMA Psychiatry the article discusses the new demands and opportunities that are emerging from the current pandemic for mental health practitioners who are using or considering the use of digital therapies.

Worldwide there is likely to be an increase in mental health problems due to isolation, illness concerns and financial and vocational uncertainty, whilst those with existing mental health conditions may be at risk of worsening symptoms.

With remote working the new norm, there is a surge of interest in digital health approaches and large numbers of platforms and apps are in rapid development. The authors, Professor Dame Til Wykes and Dr John Torous from Harvard Medical School, call for an urgent need for clinical training and skills building to be in place to ensure that new tools are implemented effectively.

New digital health platforms could be important developments from this pandemic, but the most enduring will be investment in the people, process and support to ensure telehealth cycles of interest are not tied to disasters but rather improve care every day.– Professor Dame Til Wykes, the Institute of Psychiatry, Psychology and Neuroscience, King's College London, and Dr John Torous, Harvard Medical School

The focus for these digital tools must be on application in the real world as well as technological development, according to the article, which makes the following suggestions:

Training is needed to help clinicians use technology and to build rapport via digital health tools and develop a ‘website’ manner. Research has shown that often clinicians main concern in using these tools is around developing a therapeutic relationship. Frameworks for training do exist but few have been implemented fully.

Guidance around the best way to deliver digital health is also needed and research has shown that online CBT requires some element of human interaction alongside it for it to be successful. Similarly, smartphone apps can be useful for some patients but this more than doubles if used with a clinician. There is a need to research to understand how best to implement these tools so they have the desired impact.

In order for digital health therapies for mental health to create a legacy and not simply follow the cycle of interest and abandonment seen in previous situations similar to this, there is a need for these tools to demonstrate efficacy and cost-effectiveness.

The authors recommend a deep level of patient involvement and user-testing in the development of tools to ensure new services are accessible and usable. They suggest a need to address the digital divide that still exists, especially as it is likely that those who cannot access digital therapies may be more likely to have unmet mental health needs.

Online and digital approaches to providing mental health support are incredibly important resources in this pandemic, both to help those who have existing mental health problems and those who may find themselves struggling with the current uncertainty and stress. – Professor Dame Til Wykes, the Institute of Psychiatry, Psychology and Neuroscience, King's College London

She continues, ‘To ensure these digital tools are effective and stand the test of time, they must be based on sound research and have the necessary training and support systems behind them. There must be emphasis on the delivery and implementation of digital approaches to support mental health and not just their technological development.’